FSRH CEU Statement: Availability and dispensing of Combined Vaginal Contraceptive Rings

At the time of writing of the FSRH Clinical Guideline Combined Hormonal Contraception (2019), NuvaRing® was the only available combined (ethinylestradiol 2.7mg/ etonogestrel 11.7mg) vaginal contraceptive ring (CVR) in the UK. Because of refrigeration requirements, only 3 months of Nuvaring can be dispensed at any time; this is reflected in the guideline. Other brands of ethinylestradiol/etonogestrel CVR are now available in the UK. Small studies indicate bioequivalence with NuvaRing and suggest similar tolerance. Not all brands require refrigeration.

SyreniRing® is the first of the newer brands to be listed in the British National Formulary. It does not require refrigeration and has a shelf life of two years. In contrast, NuvaRing has a shelf life of three years, but must be refrigerated prior to being dispensed, and used within 4 months after being dispensed.

In line with existing FSRH guidance, a prescription for a year of CVR use can be given if the individual is medically eligible and has had appropriate blood pressure/BMI recording. The CVR may have to be dispensed 3 months at a time (Nuvaring), but a one-year supply of some brands (e.g. SyreniRing) can be dispensed.

The full statement is available below to view and download.